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This inquiry is not now so much in its infancy as to restrain me from speaking more positively than formerly on the important point of scrophula as connected with the smallpox.

Every practitioner in medicine who has extensively inoculated with the smallpox, or has attended many of those who have had the distemper in the natural way, must acknowledge that he has frequently seen scrophulous affections, in some form or another, sometimes rather quickly shewing themselves after the recovery of the patients. Conceiving this fact to be admitted, as I presume it must be by all who have carefully attended to the subject, may I not ask whether it does not appear probable that the general introduction of the smallpox into Europe has not been among the most conductive means in exciting that formidable foe to health? Having attentively watched the effects of the cow-pox in this respect, I am happy in being able to declare that the disease does not appear to have the least tendency to produce this destructive malady.

The scepticism that appeared, even among the most enlightened of medical men when my sentiments on the important subject of the cow-pox were first promulgated, was highly laudable. To have admitted the truth of a doctrine, at once so novel and so unlike any thing that ever had appeared in the annals of medicine, without the test of the most rigid scrutiny, would have bordered upon temerity; but now, when that scrutiny has taken place, not only among ourselves, but in the first professional circles in Europe, and when it has been uniformly found in such abundant instances that the human frame, when once it has felt the influence of the genuine cow-pox in the way that has been described, is never afterwards at any period of its existence assailable by the smallpox, may I not with perfect confidence congratulate my country and society at large on their beholding, in the mild form of the cow-pox, an antidote that is capable of extirpating from the earth a disease which is every hour devouring its victims; a disease that has ever been considered as the severest scourge of the human race!






OLIVER WENDELL HOLMES was born in Cambridge, Massachusetts, August 29, 1809, and educated at Phillips Academy, Andover, and Harvard College. After graduation, he entered the Law School, but soon gave up law for medicine. He studied first in Boston, and later spent two years in medical schools in Europe, mainly in Paris. On his return he began to practise in Boston, but in two years he was appointed professor of anatomy at Dartmouth College, a position which he held from 1838 to 1840, when he again took up his Boston practise. It was soon after this, in 1843, that he published his essay on the “Contagiousness of Puerperal Fever," his only contribution of high distinction to medical science. From 1847 to 1882 he was Parkman professor of anatomy and physiology in the Harvard Medical School. He died in Boston, October 7, 1894.

In spite of the importance of the paper here printed, Holmes's reputation as a scientist was overshadowed by that won by him as a wit and a man of letters. When he was only twenty-one his "Old Ironsides" brought him into notice; and through his poetry and fiction, and the sparkling talk of the "Breakfast Table" series, he took a high place among the most distinguished group of writers that America has yet produced.



"N collecting, enforcing and adding to the evidence accumulated upon this most serious subject, I would not


be understood to imply that there exists a doubt in the mind of any well-informed member of the medical profession as to the fact that puerperal fever is sometimes communicated from one person to another, both directly and indirectly. In the present state of our knowledge upon this point I should consider such doubts merely as a proof that the sceptic had either not examined the evidence, or, having examined it, refused to accept its plain and unavoidable consequences. I should be sorry to think, with Dr. Rigby, that it was a case of " oblique vision"; I should be unwilling to force home the argumentum ad hominem of Dr. Blundell, but I would not consent to make a question of a momentous fact which is no longer to be considered as a subject for trivial discussions, but to be acted upon with silent promptitude. It signifies nothing that wise and experienced practitioners have sometimes doubted the reality of the danger in question; no man has the right to doubt it any longer. No negative facts, no opposing opinions, be they what they may, or whose they may, can form any answer to the series of cases now within the reach of all who choose to explore the records of medical science.

If there are some who conceive that any important end would be answered by recording such opinions, or by collecting the history of all the cases they could find in which no evidence of the influence of contagion existed, I believe they are in error. Suppose a few writers of authority can

Note. This essay appeared first in 1843, in The New England Quarterly Journal of Medicine, and was reprinted in the "Medical Essays "in 1855.

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